Prospective study of risk factors for increased suicide ideation and behavior following recent discharge

Links, Paul S.; Nisenbaum, Rosane; Ambreen, Munazzah; Balderson, Ken; Bergmans, Yvonne; Eynan, Rahel; Harder, Henry G.; Cutcliffe, John R.

doi:10.1016/j.genhosppsych.2011.08.016

Cited by 58 publications

(46 citation statements)

References 40 publications

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“…50 That such factors do not help patients with BPD may relate to the more impulsive nature of their suicidal behavior, minimizing protective effects of considerations captured by the Reasons For Living Inventory. The lack of effect of “depressive cognitions” is consistent with our past findings that hopelessness does not predict suicidal behavior, 14, 19 in contrast with other reports 6061,62 .…”

Section: Discussionsupporting

confidence: 91%

Life events: a complex role in the timing of suicidal behavior among depressed patients

et al. 2013

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Suicidal behavior is often conceptualized as a response to overwhelming stress. Our model posits that given a propensity for acting on suicidal urges, stressors such as life events or major depressive episodes (MDEs) determine the timing of suicidal acts.Depressed patients (n=415) were assessed prospectively for suicide attempts and suicide, life events and MDE over 2 years. Longitudinal data was divided into 1-month intervals characterized by MDE (yes/no), suicidal behavior (yes/no), and life event scores. Marginal logistic regression models were fit, with suicidal behavior as the response variable and MDE and life event score in either the same or previous month, respectively, as time-varying covariates.Among 7843 person-months, 33% had MDE and 73% had life events. MDE increased risk for suicidal behavior (OR=4.83, p< 0.0001). Life event scores were unrelated to the timing of suicidal behavior (OR=1.06 per 100 point increase, p=0.32), even during an MDE (OR=1.12, p=0.15). However, among those without Borderline Personality Disorders (BPD), both health and work related life events were key precipitants, as was recurrent MDE, with a 13-fold effect. The relationship of life events to suicidal behavior among those with BPD was more complex. Recurrent MDE was a robust precipitant for suicidal behavior, regardless of BPD comorbidity. The specific nature of life events is key to understanding the timing of suicidal behavior. Given unanticipated results regarding the role of BPD and study limitations, these findings require replication. Of note, that MDE, a treatable risk factor, strongly predicts suicidal behaviors is cause for hope.

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Section: Discussionsupporting

confidence: 91%

Life events: a complex role in the timing of suicidal behavior among depressed patients

et al. 2013

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“…Indeed, previous suicide attempt, previous psychiatric hospitalization, and personality disorder are known risk factors that favor repeated suicide attempt [9, 23, 24]. Conversely, psychiatric follow-up, treatment with psychotropic drug/s, and diagnosis of psychosocial crisis (i.e., without major psychiatric disturbance) are protective factors against repeated attempt/s.…”

Section: Discussionmentioning

confidence: 99%

Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study

et al. 2017

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BackgroundAttempted suicide is a major public health problem, and the efficacies of current postvention protocols vary. We evaluated the effectiveness of telephone follow-up of patients referred to an emergency psychiatric unit for attempted suicide on any further attempt/s over the following year.MethodIn a single-center, controlled study with intent to treat, we evaluated the efficacy of a protocol of telephone follow-up of 436 patients at 8, 30, and 60 days after they were treated for attempted suicide. As controls for comparison, we evaluated patients with similar social and demographic characteristics referred to our emergency psychiatric unit in the year prior to the study who did not receive telephone follow-up after their initial hospitalization. Data were analyzed using logistic regression.ResultsVery early telephone follow-up of our patients effectively reduced recidivism and seemed to be the only protective factor against repeated suicide attempt.ConclusionsImplementing a protocol of early telephone follow-up after attempted suicide could help prevent repeated attempt/s. More controlled studies are needed to assess optimal techniques to prevent such repetition.

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“…However, a study by Aglan and colleagues (2008) found that the long-term presence of major depression predicted deliberate self-harm over a 6-year period better than hopelessness within a sample of self-poisoning adolescents. Some studies focusing on high-risk psychiatric inpatient samples have found depression, but not hopelessness, to be a predictor of suicidal ideation, but neither depression nor hopelessness to be a predictor of suicidal behavior (Links et al, 2012; Prinstein et al, 2008). Additional longitudinal research is needed to clarify the relationship between hopelessness, depression, and suicide-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression, Suicidal Ideation, and Suicidal Behavior in High‐Risk Adolescents

Horwitz

Berona

Czyz

et al. 2016

Suicide & Life Threat Behav

122

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The relationship between hopelessness and depression in predicting suicide-related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2-4 year period. In multivariate regressions controlling for depression, suicidal ideation, and negative-expectation hopelessness, positive-expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.

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Prospective study of risk factors for increased suicide ideation and behavior following recent discharge

Cited by 58 publications

References 40 publications

Life events: a complex role in the timing of suicidal behavior among depressed patients

Life events: a complex role in the timing of suicidal behavior among depressed patients

Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression, Suicidal Ideation, and Suicidal Behavior in High‐Risk Adolescents

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